Provider Demographics
NPI:1003344334
Name:HCN EP HORIZON CITY, LLC
Entity Type:Organization
Organization Name:HCN EP HORIZON CITY, LLC
Other - Org Name:THE HOSPITALS OF PROVIDENCE HORIZON CITY CAMPUS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:SECRETARY
Authorized Official - Prefix:
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:
Authorized Official - Last Name:BUCK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:713-637-1004
Mailing Address - Street 1:8686 NEW TRAILS DR STE 100
Mailing Address - Street 2:
Mailing Address - City:THE WOODLANDS
Mailing Address - State:TX
Mailing Address - Zip Code:77381-1176
Mailing Address - Country:US
Mailing Address - Phone:713-637-1146
Mailing Address - Fax:281-298-5311
Practice Address - Street 1:13600 HORIZON BLVD
Practice Address - Street 2:SUITE 100
Practice Address - City:HORIZON CITY
Practice Address - State:TX
Practice Address - Zip Code:79928
Practice Address - Country:US
Practice Address - Phone:713-637-1146
Practice Address - Fax:281-298-5311
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-05-31
Last Update Date:2018-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282N00000XHospitalsGeneral Acute Care Hospital
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX380473401Medicaid
TX67-0124OtherMEDICARE